Order Form

Please fill out the form below. Please include all the information requested. If you do not it could cause delays in processing your order. We have included a line for your VISA, Discover Card or MasterCard number. This is not a secure email transmission so you are not required to include that information. If you prefer, you can use our Credit Card Info form. Just print out the form, fill in the blanks and fax it to us at (858) 530-1458. We are sorry for this inconvience and are working on a better way to implement the online ordering process. Thank you for your order !

*** Note: VISA, Discover Card and MasterCard are no longer accepted as payment for orders orginating outside the United States.***

The order number shown below is your tracking number. You will need this number when you correspond with us about your order. You must also enter this number in the Credit Card Info form if you plan on using that form to pay with a VISA, Discover Card or MasterCard. If you do not keep track of this number, there will be delays when you inquire about your order.

Note: Please do not forget about the $50.00US foreign order fee for orders shipping outside the United States.

ORDER NUMBER:

 Please enter in your order in the space provided below. Include the quantities of each product, the part number for each, the description and the unit price.

Quantity

Part Number

Description

Unit Price

Address

Name:

 Position:

 Company Name:

 Shipping Address Info

Shipping Address:

 City:

 Postal/Zip Code:

Province/State:

Country:

 Billing Address Info

 Only enter billing address if it is different from the shipping address.

Billing Address:

 City:

Province/State:

 Postal/Zip Code:

Country:

 Phone Number:

 E-mail Address:

Fax Number:

 Payment & Shipping

If you choose wire transfer as your preferred payment method, we will provide you with the necessary routing and account numbers. Also, you are responsible for any fees accessed by the banks. Your order will be held up if you do not pay the banking fees.

Available payment methods

Note: (VISA/MasterCard/Discover Card , Account and COD not available on orders shipping outside the United States)
  • VISA
  • MasterCard
  • Discover Card
  • COD
  • On Account
  • Pre-paid check
  • Bank wire transfer

Payment Method:

 Credit Card Number:

 Expiration Date:

 Personal or Corporate:

 Zipcode Associated with Account:

 This is usually the zipcode to which the bill is sent.

Shipping Options:

Domestic
  • UPS Ground (Brown)
  • UPS 3 Day (Orange)
  • UPS 2nd Day (Blue)
  • UPS 2nd Day A.M.(Blue - delivered in the AM)
  • UPS Overnight Saver (Red - delivered in the PM)
  • UPS Overnight (Red)
  • FedEx 2nd Day
  • FedEx Standard Overnight
  • FedEx Priority Overnight

International
  • UPS Expedited
  • UPS Express

Shipping Method:

 If collect courier, enter your courier name and account number:

 To Send in Your Request
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